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	<title>申请雷锋团认证</title>
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<body class="leifeng-apply">
<div class="wrapper noSelect">
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		<ul class="text-ul">
			<li class="clearfix"><label class="fl" >姓名</label><input id="realName" type="text" name="name" class="text" placeholder="请输入真实姓名"></li>
			<li  class="clearfix"><label class="fl">手机号 </label><input  id="phone" type="text" name="phone" class="text" placeholder="请输入11位" maxlength="11"></li>
			<li  class="clearfix"><label class="fl">地址</label><input id="address" type="text" name="address" class="text" placeholder="请输入真实地址"></li>
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		<p class="apply-p1"><span class="line"></span><span class="apply-p1-con">您擅长的领域有(多选)</span></p>
		<ul class="hobby-w">
			<li><input type="checkbox" class="checkbox" name="hobby" value="育儿"/><span>育儿</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="教育"/><span>教育</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="家政"/><span>家政</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="休闲娱乐"/><span>休闲娱乐</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="小区公共"/><span>小区公共</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="生活"/><span>生活</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="小区周边"/><span>小区周边</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="66相关"/><span>66相关</span></li>
			<li><input type="checkbox" class="checkbox" name="hobby" value="健康"/><span>健康</span></li>
		</ul>
		<a href="javascript:apply();" class="apply">申请加入</a>
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		<p class="title">申请已经提交</p>
		<p>小6客服将在48小时内给你反馈<br/>请你耐心等待哦</p>
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